Inguinal Hernia Repair (eTEP / Robotic TAPP)

Overview

An inguinal hernia — a bulge in your groin where bowel or fatty tissue has pushed through a weak spot in the abdominal wall — won't get better on its own, and it won't go away without treatment. But here's the reassuring part: fixing it is one of the most common operations performed in Australia, and Mr Nguyen does this regularly.

He performs two closely related keyhole techniques. The first is robotic TAPP (transabdominal preperitoneal — a mouthful, but it simply means small instruments pass through tiny cuts in your abdomen to reach the hernia from behind). The second is eTEP (extended totally extraperitoneal — meaning the entire repair is done in the space behind the abdominal lining, so the inside of your abdomen is never entered at all). Both approaches use just three tiny cuts — each about one centimetre — and place a large, flat mesh patch behind the weak area to reinforce it properly.

Because the mesh sits behind the muscle rather than in front of it, the repair is not under any tension. This is why these keyhole techniques tend to cause less pain after the operation, heal faster, and carry a lower chance of the hernia coming back compared to traditional open surgery.

Who needs this procedure?

• Your groin hernia is causing pain, an aching dragging feeling, or is simply stopping you from doing the things you normally do — whether that's lifting, working, or exercising
• Your hernia is stuck (this is called irreducible — meaning it won't push back in when you lie down), or it has come back after a previous repair
• You have hernias on both sides of your groin — both can be fixed in a single operation through the same three tiny cuts, so you only go through surgery once
• You're working-age or physically active and getting back to normal life quickly matters to you
• Your hernia has returned after a previous open repair — the keyhole approach comes in from a completely different direction (from behind), so it avoids the scar tissue left from the first operation
• You have a femoral hernia (a closely related type of groin hernia that sits slightly lower and deeper) — this can be found and repaired at the same time, through the same cuts

Benefits

• You'll generally feel much less sore after the operation than you would with open surgery — most people get by comfortably with regular paracetamol rather than strong prescription pain relief
• Only three tiny cuts (each roughly the size of your fingernail), which means far less risk of wound complications and barely any visible scarring
• If you have hernias on both sides, both are fixed through the same three cuts — no extra incisions and no second operation
• The large mesh patch covers the entire weak area generously, which means the hernia is less likely to come back compared to open repair
• Most people are back at a desk job within a week or two and feel genuinely themselves again well within a month
• Because the keyhole approach works from behind, it avoids cutting across the sensory nerves in your groin — this matters because long-term groin discomfort is one of the more common complaints after traditional open surgery, and this technique substantially reduces that risk

Risks & considerations

• Seroma — this is a pocket of fluid that collects in the space where the hernia sac used to sit. It happens in about 5–10 in every 100 cases, and it can look or feel like the hernia has come back. It almost always disappears on its own over a few weeks without any treatment at all, but it can be alarming if you don't know to expect it. If you notice swelling after the operation, please call us before worrying — it's very likely just this
• Mesh infection — genuinely uncommon; fewer than 1 in 100 patients experience this
• The hernia returning — about 1–3 in every 100 people at five years; this recurrence rate is lower than with open surgery
• Ongoing groin discomfort — affects roughly 1–3 people in every 100; again, lower than the rates seen after open repair
• Injury to the vas deferens (the slender tube that carries sperm) or to the blood vessels supplying the testicle — this is rare. Mr Nguyen will discuss this with you directly before your operation so you understand the real likelihood in your specific case
• General anaesthetic risks — your anaesthetist will walk you through these at your pre-operative assessment; for most healthy people, the risks are very small

Before the procedure

• If your weight is on the higher side, even a modest reduction beforehand can meaningfully lower your surgical risk — Mr Nguyen will raise this with you if it applies to your situation, without any judgment
• This operation is done under a full general anaesthetic, meaning you'll be completely asleep and won't feel or be aware of anything. You'll need a trusted person to drive you home and stay with you for the rest of that day
• No bowel preparation is needed — you don't need to take any laxatives or do anything special to your bowels
• Before your operation, Mr Nguyen will sit down with you and go through everything — what the mesh is, why it's used, the small chance of the hernia coming back, and what to do if you notice a swelling (seroma) afterwards. This is your time to ask anything at all, and you'll sign your consent form feeling properly informed — not rushed

On the day

• Once you're comfortably asleep under the general anaesthetic, Mr Nguyen makes three small incisions in your abdomen — each roughly one centimetre — to insert the keyhole instruments
• In a TAPP repair, a small opening is made in the peritoneum (the thin membrane lining the inside of your abdomen) to reach the hernia from behind. In an eTEP repair, the entire operation is carried out in the space between the abdominal muscle and that lining — so the inside of your abdomen is never entered at all
• The hernia is carefully identified and the tissue that has pushed through is gently guided back to where it belongs
• A large, lightweight mesh patch is positioned to cover the entire weak area — this is the foundation of the repair and what prevents the hernia from returning
• If a TAPP approach was used, the peritoneal lining is closed back over the mesh. All three small cuts are then neatly closed
• You'll wake up comfortably in the recovery room. After a few hours in the day-stay unit while the anaesthetic fully wears off, most people are ready to go home on the same day

Recovery & aftercare

• Day of surgery and the day after: Rest at home. You'll notice some groin soreness, and possibly some bloating or shoulder discomfort from the gas used during the keyhole procedure — this is normal and passes within a day or two. Regular paracetamol taken as directed on the packet handles this well for most people. Take it easy and let someone look after you
• Days 2–3: You should be moving around the house comfortably and able to look after yourself. Short, gentle walks are actively encouraged — your body heals better when it's gently moving
• After 1 week: Most people feel ready to return to a desk-based or office job. You can drive again once you're confident you could do an emergency stop without hesitation — usually within a few days to a week. If in doubt, wait a little longer
• After 4–6 weeks: You can return to manual work, the gym, sport, and all the activities you enjoy. This is the milestone most active people are working towards
• For those first 4–6 weeks, please avoid lifting anything heavier than about 10 kg — this gives the mesh time to settle in and the repair to bond and strengthen properly
• Sexual activity is fine again after about 2–3 weeks, whenever you feel comfortable
• A follow-up appointment with Mr Nguyen is routinely scheduled 2–6 weeks after your operation — this review is provided at no charge, and it's your chance to ask any questions that have come up during recovery

Related patient guides

These guides are written in plain language for you and the people supporting you — to help answer the questions that usually come up before and after this type of surgery. Have a read before your appointment so you come in feeling prepared rather than overwhelmed.